Are there any residencies I *certainly* can't get into as a DO?

[allenyoung96]

Or are all of them fair game? I'm a matriculating OMS-1, sorry for the naivety of the question. Am I pretty much excluded from specialties like dermatology and radiology?

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[seanm028]

No. There might be a few specific programs, but definitely not any whole fields that are off-limits.

 

[allenyoung96]

No. There might be a few specific programs, but definitely not any whole fields that are off-limits.

Damn, I heard my friend tell me it's pretty much impossible for a DO to get into dermatology.

 

[benruitz98]

Damn, I heard my friend tell me it's pretty much impossible for a DO to get into dermatology.

Are you attending a private or state DO school? If private - is it one of the "better ones"?

SAP Crystal Reports - (kinstacdn.com)

If you look at the charting outcomes then it is nearly "impossible". Your chances are helped by attending a "good" DO school that has its own GME or strong connections, good research, perform stellar on Step 2, and network like crazy. These things are all much harder to do as a DO and some people might be rockstars clinically but perform poorly on tests so therefore they might self-select for a lesser competitive specialty than derm (which is even hella competitive for MDs)

For what it's worth my friends all wanted surgical subspecialties and one wanted cardiology but after getting beat down by first year they decided they want out of the rat race and just went into IM and FM. Freed up a ton of time during MS to vacation and develop their hobbies, one even got married. Short residency, make $250-$300k - they're pretty happy so far.

 

[drstranger]

Damn, I heard my friend tell me it's pretty much impossible for a DO to get into dermatology.

5/30 matched this year in derm from DO schools, so it's possible but hard.

 

[benruitz98]

5/30 matched this year in derm from DO schools, so it's possible but hard.

OP's post history suggests they're going to CHSU-COM so it probably is impossible considering their inaugural class will match in 2024 and they're in cali which is uber competitive even for specialties like IM. DOs typically needed 240-250 just to land a good IM program in a desirable city in cali. Anything non-surgical is still on the table with good scores and being okay with a community program anywhere in the country.

 

[allenyoung96]

OP's post history suggests they're going to CHSU-COM so it probably is impossible considering their inaugural class will match in 2024 and they're in cali which is uber competitive even for specialties like IM. DOs typically needed 240-250 just to land a good IM program in a desirable city in cali. Anything non-surgical is still on the table with good scores and being okay with a community program anywhere in the country.

Even surgery would be off the table?

 

[seanm028]

Even surgery would be off the table?

Nothing is off the table, per se. But the ball is in your court. Like @benruitz98 said above, some of the things that are within your control are "good research, perform stellar on Step 2, and network like crazy". There's a lot of work, but if it's what you want, it's doable. Just know what you're getting yourself into.

 

[drstranger]

OP's post history suggests they're going to CHSU-COM so it probably is impossible considering their inaugural class will match in 2024 and they're in cali which is uber competitive even for specialties like IM. DOs typically needed 240-250 just to land a good IM program in a desirable city in cali. Anything non-surgical is still on the table with good scores and being okay with a community program anywhere in the country.

Totally disagree, matching super competitive specialties is way more on the student than on the school. ex. BCOM inaugural class matching urology, derm, ortho and optho. Make connections early and do as much research as you can and you will be able to open doors. Work hard if derm is what you want.

Even surgery would be off the table?

no not at all, still a little hard to match from any DO school but totally possible.

 

[allenyoung96]

Totally disagree, matching super competitive specialties is way more on the student than on the school. ex. BCOM inaugural class matching urology, derm, ortho and optho. Make connections early and do as much research as you can and you will be able to open doors. Work hard if derm is what you want.


no not at all, still a little hard to match from any DO school but totally possible.

Even if my med school is brand new?

 

[drstranger]

Even if my med school is brand new?

yes, see my example. it is possible but just a little harder.

 

[seanm028]

Even if my med school is brand new?

I think you're missing the point. Yes, certain factors make your journey easier or harder (prestige of school, newness of school, etc.). But at the end of the day, it's really on you. There have been DOs from unimpressive schools who matched neurosurgery, and there have been MDs from Harvard who didn't match (probably... I'm not actually looking that up). If you really want derm or radiology or whatever, then grab the bull by the horns. Start doing research as early as you possibly can. Start networking as early as you possibly can, and do it well. Start studying for the USMLE to make sure you crush Step 2 (COMLEX is important, but the really competitive residencies will require USMLE).

 

[benruitz98]

Totally disagree, matching super competitive specialties is way more on the student than on the school. ex. BCOM inaugural class matching urology, derm, ortho and optho. Make connections early and do as much research as you can and you will be able to open doors. Work hard if derm is what you want.


no not at all, still a little hard to match from any DO school but totally possible.

That's true to an extent

if you randomly picked 20 harvard students they probably all have 230+ step, research, etc - which are all things they probably had in undergrad (and it's easier to continue building on these skills)

However, picking a random 20 students from a DO school likely means they had deficiencies somewhere whether that is low MCAT, low GPA, no research, bad luck, being a cali applicant. But if that DO student had stellar stats/app but didn't make it to MD due to bad luck/poor school list then they can likely grind their way into something decent.

Like the data shows, only 5 DO applicants matched derm. I am sure that ALL 30 were equally as impressive, and I'm sure that some of the 25 that didn't match were MORE impressive than some of the 5 that did - but at the end of the day there's a limited number of spots.

IMO it's better to gun for something like gas or low-tier gen surg program and have a good chance of matching than to gun for derm or ENT, and end up matching backup IM/FM and being miserable.

I've seen MD students fail to match ENT and then end up securing top-notch research gigs at harvard. They had the stats and everything but things don't always work out - and this is amplified for DOs.

Where I live DOs and IMGs fight tooth and nail to match some of the gas/rads programs and there are virtually no USMD in them. If I didn't care about prestige and wanted to goof off and barely pass I'd have an easier time just walking into one of these programs because they'd love to brag about matching a USMD.

 

[Chads2]

To the OP,

As a matriculating OMS-1, now is a good time to learn about evidence based medicine, quality of evidence, particularly anecdotal evidence.

“I know someone who...” is anecdotal evidence. Meanwhile “School X matched one each in (these competitive specialties)” has a small n, and questionable if the data is applicable to your situation. If you found “match data for the first three classes of all new DO schools in the last 20 years,” then you MAY find data with a significant enough n to apply it to your situation...and even then you may be the superstar who is the statistical outlier.

Then there is the quality of evidence known as “expert opinion,” which is of course what you get on SDN.

All kidding aside...worry about that stuff later. You’re not going to change the school you’re going to or the DO after your name, should you eventually earn it. Focus more on learning, and becoming a good doctor of whatever specialty the next 3 years tells you that you are destined to be.

 

[allenyoung96]

To the OP,

As a matriculating OMS-1, now is a good time to learn about evidence based medicine, quality of evidence, particularly anecdotal evidence.

“I know someone who...” is anecdotal evidence. Meanwhile “School X matched one each in (these competitive specialties)” has a small n, and questionable if the data is applicable to your situation. If you found “match data for the first three classes of all new DO schools in the last 20 years,” then you MAY find data with a significant enough n to apply it to your situation...and even then you may be the superstar who is the statistical outlier.

Then there is the quality of evidence known as “expert opinion,” which is of course what you get on SDN.

All kidding aside...worry about that stuff later. You’re not going to change the school you’re going to or the DO after your name, should you eventually earn it. Focus more on learning, and becoming a good doctor of whatever specialty the next 3 years tells you that you are destined to be.

That's a good point. I mean I've looked at the NRMP residency data and I believe that's as close as I can get to the 'actual' answer to my question. I am in a special position though where anecdotal evidence / expert opinions are put into consideration. (e.g. getting into a newer DO school).

I want to go and I ABSOLUTELY want to practice medicine. However, I don't want to end up like this The Stain where I have decent scores and performance reviews and still don't get into a residency that is even somewhat decent.

Even the person above me is grouping IMGs and DOs in the same category as far as 'competition' which is worrying to say the least.

 

[benruitz98]

Even the person above me is grouping IMGs and DOs in the same category as far as 'competition' which is worrying to say the least.

I didn't say that to equate DO to IMG in any way. Everyone knows DO>IMG in terms of probability of matching for the student. It depends on the program. There are a few near me that prefer FMGs (usually have tons of experience from their home country) to IMGs/DOs because they can essentially overwork them and they won't complain cuz they can hang a visa over their head. They maximize revenue and don't have to do as much teaching.

You have to find programs where you can see yourself "fit" and work towards becoming that person.

 

[Chads2]

I want to go and I ABSOLUTELY want to practice medicine. However, I don't want to end up like this The Stain

I tell my residents and students all the time that I wonder how I ever got into med school and subsequently how I ever got into residency. And to tell you the truth, I never spent a day of those years wanting to be a dermatologist or an orthopedist or a urologist. And that’s probably what made me fortunate enough to enjoy what I was learning from my superiors and from my patients, given that I never gave much thought to being Uber-competitive or learning how to ace standardized tests. On the other hand, had I done so, maybe I’d be enjoying a better lifestyle today.
The point of this wise-old-fart story of mine, though, is to not get caught up in the match results and what someone in your shoes can and cannot do, but rather what YOU are GOING TO DO. Maybe you’ll find you don’t enjoy skin and bones/joints and eyeballs, but healthy kids or expectant mothers instead.

 

[benruitz98]

I tell my residents and students all the time that I wonder how I ever got into med school and subsequently how I ever got into residency. And to tell you the truth, I never spent a day of those years wanting to be a dermatologist or an orthopedist or a urologist. And that’s probably what made me fortunate enough to enjoy what I was learning from my superiors and from my patients, given that I never gave much thought to being Uber-competitive or learning how to ace standardized tests. On the other hand, had I done so, maybe I’d be enjoying a better lifestyle today.
The point of this wise-old-fart story of mine, though, is to not get caught up in the match results and what someone in your shoes can and cannot do, but rather what YOU are GOING TO DO. Maybe you’ll find you don’t enjoy skin and bones/joints and eyeballs, but healthy kids or expectant mothers instead.

A wise adcom from my school told me that the people he's found to miserable are the ones who did a competitive specialty just because they could (had high stats) and also those who did what they were "passionate" about. His advice was to avoid burnout was to do something tolerable because at the end of the day it's just a job and its better to enjoy life outside of work.

 

[drstranger]

That's true to an extent

if you randomly picked 20 harvard students they probably all have 230+ step, research, etc - which are all things they probably had in undergrad (and it's easier to continue building on these skills)

However, picking a random 20 students from a DO school likely means they had deficiencies somewhere whether that is low MCAT, low GPA, no research, bad luck, being a cali applicant. But if that DO student had stellar stats/app but didn't make it to MD due to bad luck/poor school list then they can likely grind their way into something decent.

Like the data shows, only 5 DO applicants matched derm. I am sure that ALL 30 were equally as impressive, and I'm sure that some of the 25 that didn't match were MORE impressive than some of the 5 that did - but at the end of the day there's a limited number of spots.

IMO it's better to gun for something like gas or low-tier gen surg program and have a good chance of matching than to gun for derm or ENT, and end up matching backup IM/FM and being miserable.

I've seen MD students fail to match ENT and then end up securing top-notch research gigs at harvard. They had the stats and everything but things don't always work out - and this is amplified for DOs.

Where I live DOs and IMGs fight tooth and nail to match some of the gas/rads programs and there are virtually no USMD in them. If I didn't care about prestige and wanted to goof off and barely pass I'd have an easier time just walking into one of these programs because they'd love to brag about matching a USMD.

cool, I was not referring to USMD at all in this conversation so no point for this input.

 

[Goro]

Damn, I heard my friend tell me it's pretty much impossible for a DO to get into dermatology.

My school has sent people into Derm.

 

[Goro]

Even if my med school is brand new?

I think that you need to be realistic and understand that you will most likely be going into Primary Care or the other DO loving specialties, like EM, PM&R, Neuro, Path, Rads and Gas.

 

[benruitz98]

I think that you need to be realistic and understand that you will most likely be going into Primary Care or the other DO loving specialties, like EM, PM&R, Neuro, Path, Rads and Gas.

This. First focus on just making it through and passing without any red flags, especially going to a new (for-profit) school where they're still working out the kinks in the curriculum and rotations. Next, if you happen to do well on your boards and research then you can consider options. Prepare for the worst but hope for the best, that way you won't be upset if you don't get what you want.

 

[drducky.]

I think that you need to be realistic and understand that you will most likely be going into Primary Care or the other DO loving specialties, like EM, PM&R, Neuro, Path, Rads and Gas.

The truth hurts

 

[allenyoung96]

The truth hurts

Not really. I just wanted a realistic assessment and I appreciate it.

 

[Angus Avagadro]

Damn, I heard my friend tell me it's pretty much impossible for a DO to get into dermatology.

One of my students starts July 1.

 

[Angus Avagadro]

I think that you need to be realistic and understand that you will most likely be going into Primary Care or the other DO loving specialties, like EM, PM&R, Neuro, Path, Rads and Gas.

This might help.
Radiology will keep DO friendly as many aren't going into it. It is basically sit in a closet, or home and do piece work all day. Very little interaction with other docs . Basically, all about throughput. Our local MD Uni med school matched 1 out of the entire class in DR.

 

[DOVinciRobot]

5/30 matched this year in derm from DO schools, so it's possible but hard.

No, that’s only for pgy-1 derm positions which is a tiny fraction of actual Derm slots. Most are pgy-2.

Even surgery would be off the table?

I made a thread on matching General Surgery as a DO in the DO Student forum, if you have any interest in surgery I recommend reading it. Yes GS is very possible, but you have to check off some specific boxes.

Like the data shows, only 5 DO applicants matched derm. I am sure that ALL 30 were equally as impressive, and I'm sure that some of the 25 that didn't match were MORE impressive than some of the 5 that did - but at the end of the day there's a limited number of spots.

Again, that statistic isn’t true. Most Derm positions are pgy-2, and that stat is only for pgy-1.

36 DO seniors matched Dermatology this match cycle.

OP if you go to a brand new school you should be fully aware you have a much higher chance of going into primary care and other traditional DO specialties than if you even went to an established DO school. I do not recommend attending a new school.

 

[Ho0v-man]

No field is off the table. Certain programs in every field are though. Only the really good DO schools like OSU, MSU, and TCOM actually have resources that help you match into the Uber competitive specialties. So that is limiting. The research you’ll need to do to match those fields will have to be found outside of your school just like almost any other DO school. But it’s possible. My school had a derm match at a former AOA program and an MD university neurosurgery match.

I matched very well into rads as a DO. It’s a notch down in competitiveness from surgical fields and derm.

While the lack of resources at an osteopathic school as well as the bias against DOs are valid points as to why we struggle to match these fields; the biggest reason is that the majority of DO students simply don’t have the insane drive needed to do this stuff.

People like to point out that it’s worse at new schools because the schools are worse and inexperienced. There’s some truth to that, too. But its probably more to do with just taking a lot of applicants who aren’t that strong academically. It’s not the schools fault that these students can’t all be brain surgeons when the majority of the class is struggling to get through at all.

 

[benruitz98]

People like to point out that it’s worse at new schools because the schools are worse and inexperienced. There’s some truth to that, too. But its probably more to do with just taking a lot of applicants who aren’t that strong academically. It’s not the schools fault that these students can’t all be brain surgeons when the majority of the class is struggling to get through at all.

This is very true. If most of the class at a newer school is ~3.2/502 and barely struggling to pass then the school can only do so much. I would also argue that being around people with higher stats (515/3.8) - not using the word "smart" to avoid offending anyone - can rub off on you. I'm certainly not a genius but the people at my school have MUCH higher stats than I do and I've been able to rise up to their level just by being around them, learning from them (they usually have an instinct of how to study efficiently when presented with new material), etc.

 

[Angus Avagadro]

This is very true. If most of the class at a newer school is ~3.2/502 and barely struggling to pass then the school can only do so much. I would also argue that being around people with higher stats (515/3.8) - not using the word "smart" to avoid offending anyone - can rub off on you. I'm certainly not a genius but the people at my school have MUCH higher stats than I do and I've been able to rise up to their level just by being around them, learning from them (they usually have an instinct of how to study efficiently when presented with new material), etc.

Well, that is the Chicken Salad controversy, isn't it? I would say IMO, the bottom third at my school,(an established DO school with a good match record,) won't match competitive specialties because , for lack of a better word, they won't be competitive. And the bottom third at your average MD school won't do much better. Med school is a big step up for most, save the elite students. The upper third at our school adapt quite well and have good match results. Med school is what each student makes it. If one attends a new school, they are not completely shut out of anything not primary care, but there are additional hurdles to overcome. To be successful, one must set realistic goals, understand the current market/matching process, and apply to programs they would be competitive with the stats they earned. This may require moving around the country. I still don't recommend new schools unless there is no other option.

 

[benruitz98]

Well, that is the Chicken Salad controversy, isn't it? I would say IMO, the bottom third at my school,(an established DO school with a good match record,) won't match competitive specialties because , for lack of a better word, they won't be competitive. And the bottom third at your average MD school won't do much better. Med school is a big step up for most, save the elite students. The upper third at our school adapt quite well and have good match results. Med school is what each student makes it. If one attends a new school, they are not completely shut out of anything not primary care, but there are additional hurdles to overcome. To be successful, one must set realistic goals, understand the current market/matching process, and apply to programs they would be competitive with the stats they earned. This may require moving around the country. I still don't recommend new schools unless there is no other option.

I would disagree with this statement. The bottom third at my MD school can walk into good academic IM programs, gas, rads, etc without much trouble - the same can't be said for the bottom third of most DO.

The bottom third of any MD school still had to pass Step 1 whereas the bottom third of many DOs (and in some cases the bottom 50%) did not take USMLE and only took COMLEX (with avg to below avg scores). The bottom third of my school still had the same quality of clinical rotations as the top 70%. With DO its a mixed bag. I have DO friends starting residency in July who haven't touched a patient since March 2020.

Even if you compare a DO school with a nearby low-tier MD school, they might have "similar" percentages of primary care vs specialty but 100% of the time the MD school matches will be at more prestigious institutions (and for IM this means GI/Cardio fellowships). My "low-tier" school has sent people to MGH and similar caliber programs, no DO school can say that - maybe they don't care where they end up, fine. Point is, these MGH IM matches could have easily been a lower-tier ENT, ophtho, etc. The most prestigious IM match of any DO doesn't translate in the same way.

I follow a non-famous plastic surgeon on Instagram and I was shocked to learn he graduated from SGU. I looked him up and it took him over 10 years (gen surg -> research -> fellowship) to accomplish it. You can even tell he looks 50 when he's only in his late 30s. That doesn't mean "Oh just go to SGU and you can do plastic surgery no problem"

This video couldn't have come at a better time. The data doesn't lie.


If you want to equate the bottom third of MD to bottom third of DO, or any comparisons at all then make USMLE a graduation requirement for all DOs. This would do more harm than good. Strong schools like KCU, TCOM, etc might only lose 10-15% of their students but weaker schools like LMU, KYCOM, will lose 40-50% who aren't able to pass at all. These people would have otherwise been a great asset to their community as family doctors or hospitalists. Schools will be forced to matriculate OOS (mostly Cali kids with higher stats) over their own community members (typically weaker stats) and it would greatly increase health disparities in their community.

 

[drducky.]

I would disagree with this statement. The bottom third at my MD school can walk into good academic IM programs, gas, rads, etc without much trouble - the same can't be said for the bottom third of most DO.

The bottom third of any MD school still had to pass Step 1 whereas the bottom third of many DOs (and in some cases the bottom 50%) did not take USMLE and only took COMLEX (with avg to below avg scores). The bottom third of my school still had the same quality of clinical rotations as the top 70%. With DO its a mixed bag. I have DO friends starting residency in July who haven't touched a patient since March 2020.

Even if you compare a DO school with a nearby low-tier MD school, they might have "similar" percentages of primary care vs specialty but 100% of the time the MD school matches will be at more prestigious institutions (and for IM this means GI/Cardio fellowships). My "low-tier" school has sent people to MGH and similar caliber programs, no DO school can say that - maybe they don't care where they end up, fine. Point is, these MGH IM matches could have easily been a lower-tier ENT, ophtho, etc. The most prestigious IM match of any DO doesn't translate in the same way.

I follow a non-famous plastic surgeon on Instagram and I was shocked to learn he graduated from SGU. I looked him up and it took him over 10 years (gen surg -> research -> fellowship) to accomplish it. You can even tell he looks 50 when he's only in his late 30s. That doesn't mean "Oh just go to SGU and you can do plastic surgery no problem"

This video couldn't have come at a better time. The data doesn't lie.


If you want to equate the bottom third of MD to bottom third of DO, or any comparisons at all then make USMLE a graduation requirement for all DOs. This would do more harm than good. Strong schools like KCU, TCOM, etc might only lose 10-15% of their students but weaker schools like LMU, KYCOM, will lose 40-50% who aren't able to pass at all. These people would have otherwise been a great asset to their community as family doctors or hospitalists. Schools will be forced to matriculate OOS (mostly Cali kids with higher stats) over their own community members (typically weaker stats) and it would greatly increase health disparities in their community.

I agree with mostly everything but i really doubt half of any DO school would fail the usmle lol

 

[benruitz98]

I agree with mostly everything but i really doubt half of any DO school would fail the usmle lol

I have friends who did not take USMLE because they simply couldn't score higher than a 180 on their NBME. And their class average was ~210 with only 30-40% taking it. If you forced the other 60% to take it probably 40% would have failed and 20% barely passed. A good chunk also drop out/withdraw prior to boards for academic reasons. For example, KYCOM had a ~60% first time comlex pass rate 10 years ago. It's improved since. Their average MCAT back then was the equivalent of a 492 today. LMU, WCU, UIWSOM etc are similar. They're always fluctuating between 15-20% not passing boards (first time or at all), not including 1st/2nd year dropouts.

Now maybe you attend a good school like KCU which I believe 3/4 take USMLE and average 228? Yea the other 25% or so probably could pass it (at least 20% of them)--- that's a different caliber than the bottom-tier schools.

 

[Angus Avagadro]

1. The specialties you mention, are not competitive. Ortho, Neurosurgery, IR, Ent, urology are.
2. Your bottom third are not matching IM at Man's Best Hospital or Integrative Plastics anywhere,, unless parents are plastic surgeons donating millions to the med school. Maybe Ortho at U Toledo, (sorry Toledo, nothing personal). I have students at Hopkins, Mayo Jax, Shands,U Cincinatti, Pitt, etc., to name a few. Not bottom third tbh.
3. No med school can have all of it's students rotate through the mother ship. They get farmed out to crappy rotations too. Happened where my wife graduated and where I was faculty.
4. My school requires all students to take and pass USMLE.
5. Your posted video is a commercial for a med school consulting service. It only refers to plastic surgery as a competitive specialty out of reach for most DOs. Well, there were only 180 plastic residency spots in 2020. I would say that plastic surgery is out of reach for all of the bottom third at your or any MD school.
6. I am.not disputing DOs have a tougher road. That's what makes them good residents.
7. Matching got tougher last year for MDs and DOs. Both dropped several percentage points on overall match rates before the SOAP. It will continue to get tougher until more slots open up.

 

[Goro]

I would disagree with this statement. The bottom third at my MD school can walk into good academic IM programs, gas, rads, etc without much trouble - the same can't be said for the bottom third of most DO.

The bottom third of any MD school still had to pass Step 1 whereas the bottom third of many DOs (and in some cases the bottom 50%) did not take USMLE and only took COMLEX (with avg to below avg scores). The bottom third of my school still had the same quality of clinical rotations as the top 70%. With DO its a mixed bag. I have DO friends starting residency in July who haven't touched a patient since March 2020.

Even if you compare a DO school with a nearby low-tier MD school, they might have "similar" percentages of primary care vs specialty but 100% of the time the MD school matches will be at more prestigious institutions (and for IM this means GI/Cardio fellowships). My "low-tier" school has sent people to MGH and similar caliber programs, no DO school can say that - maybe they don't care where they end up, fine. Point is, these MGH IM matches could have easily been a lower-tier ENT, ophtho, etc. The most prestigious IM match of any DO doesn't translate in the same way.

I follow a non-famous plastic surgeon on Instagram and I was shocked to learn he graduated from SGU. I looked him up and it took him over 10 years (gen surg -> research -> fellowship) to accomplish it. You can even tell he looks 50 when he's only in his late 30s. That doesn't mean "Oh just go to SGU and you can do plastic surgery no problem"

This video couldn't have come at a better time. The data doesn't lie.


If you want to equate the bottom third of MD to bottom third of DO, or any comparisons at all then make USMLE a graduation requirement for all DOs. This would do more harm than good. Strong schools like KCU, TCOM, etc might only lose 10-15% of their students but weaker schools like LMU, KYCOM, will lose 40-50% who aren't able to pass at all. These people would have otherwise been a great asset to their community as family doctors or hospitalists. Schools will be forced to matriculate OOS (mostly Cali kids with higher stats) over their own community members (typically weaker stats) and it would greatly increase health disparities in their community.

Jeeze, somebody was triggered.

Just spare us the MD vs. DO jive okay? Let's get back on track

 

[Ho0v-man]

I would disagree with this statement. The bottom third at my MD school can walk into good academic IM programs, gas, rads, etc without much trouble - the same can't be said for the bottom third of most DO.

The bottom third of any MD school still had to pass Step 1 whereas the bottom third of many DOs (and in some cases the bottom 50%) did not take USMLE and only took COMLEX (with avg to below avg scores). The bottom third of my school still had the same quality of clinical rotations as the top 70%. With DO its a mixed bag. I have DO friends starting residency in July who haven't touched a patient since March 2020.

Even if you compare a DO school with a nearby low-tier MD school, they might have "similar" percentages of primary care vs specialty but 100% of the time the MD school matches will be at more prestigious institutions (and for IM this means GI/Cardio fellowships). My "low-tier" school has sent people to MGH and similar caliber programs, no DO school can say that - maybe they don't care where they end up, fine. Point is, these MGH IM matches could have easily been a lower-tier ENT, ophtho, etc. The most prestigious IM match of any DO doesn't translate in the same way.

I follow a non-famous plastic surgeon on Instagram and I was shocked to learn he graduated from SGU. I looked him up and it took him over 10 years (gen surg -> research -> fellowship) to accomplish it. You can even tell he looks 50 when he's only in his late 30s. That doesn't mean "Oh just go to SGU and you can do plastic surgery no problem"

This video couldn't have come at a better time. The data doesn't lie.


If you want to equate the bottom third of MD to bottom third of DO, or any comparisons at all then make USMLE a graduation requirement for all DOs. This would do more harm than good. Strong schools like KCU, TCOM, etc might only lose 10-15% of their students but weaker schools like LMU, KYCOM, will lose 40-50% who aren't able to pass at all. These people would have otherwise been a great asset to their community as family doctors or hospitalists. Schools will be forced to matriculate OOS (mostly Cali kids with higher stats) over their own community members (typically weaker stats) and it would greatly increase health disparities in their community.

I overall agree with this. The worst students at a USMD school are able to fall backwards into those types of specialties.

This is a example of a general rule of tiers. The tier of your school isn’t determined by your best students. The top 5-10 at any med school in the country are going to be absolute beasts. The tier of your school is determined by your worst students. And there’s a huge disparity between the worst students at an MD vs a DO school.

This also ignores the bias DOs face. A 215 USMD still has options beyond primary care. A DO usually doesn’t.

I actually do think the majority of DOs could pass the USMLE exams. Speaking from personal experience, there’s so much temptation as a DO student in dedicated to just stop torturing yourself and quit on the USMLE. If MDs were given the option, I’d think a good bit would quit it too. And I think if DOs didn’t have the comlex-only pathway forward, we’d be fine. But this is off topic.

 

[drducky.]

I overall agree with this. The worst students at a USMD school are able to fall backwards into those types of specialties.

This is a example of a general rule of tiers. The tier of your school isn’t determined by your best students. The top 5-10 at any med school in the country are going to be absolute beasts. The tier of your school is determined by your worst students. And there’s a huge disparity between the worst students at an MD vs a DO school.

This also ignores the bias DOs face. A 215 USMD still has options beyond primary care. A DO usually doesn’t.

I actually do think the majority of DOs could pass the USMLE exams. Speaking from personal experience, there’s so much temptation as a DO student in dedicated to just stop torturing yourself and quit on the USMLE. If MDs were given the option, I’d think a good bit would quit it too. And I think if DOs didn’t have the comlex-only pathway forward, we’d be fine. But this is off topic.

Isnt studying for the usmle the same as comlex though? Why would they randomly drop one?

 

[benruitz98]

Isnt studying for the usmle the same as comlex though? Why would they randomly drop one?

lol....... what year are you? I've looked at COMLEX style questions and they're so poorly written that they don't even come close to the quality of USMLE. Not to mention anyone can just brute force memorize a bunch of OMM and boost their scores.

COMLEX %ile =/ USMLE %ile

From what I've seen a 450-480 (400 is passing) indicates a high risk for passing USMLE (194 for a basic level of competency)

The Use of COMLEX-USA and USMLE for Residency Applicant Selection - PubMed (nih.gov)

Relationship between COMLEX and USMLE scores among osteopathic medical students who take both examinations - PubMed (nih.gov)

COMLEX-1 and USMLE-1 are not interchangeable examinations - PubMed (nih.gov)
Read this ^ if you have time.

Reminds me of a "medfluencer" on IG who made a video making fun of her failing to pass any NBME in 6+ months of studying like a week out from her step 1 (she probably canceled it). Then 2 weeks later making a "USMLE Step 1 Guide" LOL.

 

[Goro]

Nothing like using an 11 year old paper which talks about data taken from the 2005 2006 cycle as your data point.

I agree that they are two different exams, with different focuses in terms of subject material, and that step I is much better written exam than COMLEX I.

 

[drducky.]

lol....... what year are you? I've looked at COMLEX style questions and they're so poorly written that they don't even come close to the quality of USMLE. Not to mention anyone can just brute force memorize a bunch of OMM and boost their scores.

COMLEX %ile =/ USMLE %ile

From what I've seen a 450-480 (400 is passing) indicates a high risk for passing USMLE (194 for a basic level of competency)

The Use of COMLEX-USA and USMLE for Residency Applicant Selection - PubMed (nih.gov)

Relationship between COMLEX and USMLE scores among osteopathic medical students who take both examinations - PubMed (nih.gov)

COMLEX-1 and USMLE-1 are not interchangeable examinations - PubMed (nih.gov)
Read this ^ if you have time, unlike certain "adcoms" who are taking a break from bullying premeds adding nothing of value to this discussion

Reminds me of a "medfluencer" on IG who made a video making fun of her failing to pass any NBME in 6+ months of studying like a week out from her step 1 (she probably canceled it). Then 2 weeks later making a "USMLE Step 1 Guide" LOL.

Ya but say you’re using first aid to study for both, and you go “im tired of this, step1 is too hard, im cancelling it”, and you go right back to studying from first aid

 

[benruitz98]

Ya but say you’re using first aid to study for both, and you go “im tired of this, step1 is too hard, im cancelling it”, and you go right back to studying from first aid

I don't understand what you're saying? Are you saying that people who busted their ass to get into medical school all of a sudden decide to call it quits and not study a little bit more for a difficult exam - an exam that can drastically impact their 30-50 year career?

Nobody capable of passing decides to just "not take USMLE". Those who never take it are the ones who can't get a passing NBME score after weeks and months of studying.

 

[DrStephenStrange]

lol....... what year are you? I've looked at COMLEX style questions and they're so poorly written that they don't even come close to the quality of USMLE. Not to mention anyone can just brute force memorize a bunch of OMM and boost their scores.

COMLEX %ile =/ USMLE %ile

From what I've seen a 450-480 (400 is passing) indicates a high risk for passing USMLE (194 for a basic level of competency)

The Use of COMLEX-USA and USMLE for Residency Applicant Selection - PubMed (nih.gov)

Relationship between COMLEX and USMLE scores among osteopathic medical students who take both examinations - PubMed (nih.gov)

COMLEX-1 and USMLE-1 are not interchangeable examinations - PubMed (nih.gov)
Read this ^ if you have time, unlike certain "adcoms" who are taking a break from bullying premeds adding nothing of value to this discussion

Reminds me of a "medfluencer" on IG who made a video making fun of her failing to pass any NBME in 6+ months of studying like a week out from her step 1 (she probably canceled it). Then 2 weeks later making a "USMLE Step 1 Guide" LOL.

How do you explain the 220+ USMLE sub-450 COMLEX students? Yes, USMLE is written better, and yes they can be very different exams in style, but I've seen people do well on COMLEX and fail/score low on the USMLE and vice versa.

 

[benruitz98]

How do you explain the 220+ USMLE sub-450 COMLEX students? Yes, USMLE is written better, and yes they can be very different exams in style, but I've seen people do well on COMLEX and fail/score low on the UMSLE and vice versa.

Those people are the minority and they're vocal about it. The data shows that the average DO has a higher %ile COMLEX than USMLE.
Probably due to a combination of

The DO average isn't even a 220. I believe SGU is 221. KCU 228 (most but not everyone takes it), a few "top" DO schools in the 215-ish range, the low tiers around 210.

Most USMD average 230-245 and the average is brought down by DO/IMG.

1) Study plan focused on Step 1 (No Comquest or whatever)
2) Wanted to just pass COMLEX because their NBMEs were high enough
3) Were tired/burnt out after step and took COMLEX 3-7 days later
4) Didn't study any OMM (I believe you folks call it "green book")

Similarly, you can make the argument that anyone can become a millionaire straight out of high school without college - by driving a truck then becoming an owner-operator and hiring others, or becoming a mechanic and buying their own shop. But again - minority of people do that.

I could care less what my doctor scored on step. In fact, many of mine have been DOs. There are lots of amazing doctors out there with low scores.

 

[Ho0v-man]

Those people are the minority and they're vocal about it. The data shows that the average DO has a higher %ile COMLEX than USMLE.
Probably due to a combination of

The DO average isn't even a 220. I believe SGU is 221. KCU 228 (most but not everyone takes it), a few "top" DO schools in the 215-ish range, the low tiers around 210.

Most USMD average 230-245 and the average is brought down by DO/IMG.

1) Study plan focused on Step 1 (No Comquest or whatever)
2) Wanted to just pass COMLEX because their NBMEs were high enough
3) Were tired/burnt out after step and took COMLEX 3-7 days later
4) Didn't study any OMM (I believe you folks call it "green book")

Similarly, you can make the argument that anyone can become a millionaire straight out of high school without college - by driving a truck then becoming an owner-operator and hiring others, or becoming a mechanic and buying their own shop. But again - minority of people do that.

I could care less what my doctor scored on step. In fact, many of mine have been DOs. There are lots of amazing doctors out there with low scores.

I took step 1 2 years ago and the average was 231. This number is not brought down by IMGs and DOs.

I don't understand what you're saying? Are you saying that people who busted their ass to get into medical school all of a sudden decide to call it quits and not study a little bit more for a difficult exam - an exam that can drastically impact their 30-50 year career?

Nobody capable of passing decides to just "not take USMLE". Those who never take it are the ones who can't get a passing NBME score after weeks and months of studying.

Lots of people capable of passing don’t. Primarily because they know they won’t hit a high enough number to really improve their chances at whatever specialty. Or they just genuinely don’t care. I think this gets overblown on SDN a little bit. While essentially every DO student wanted to go MD, a lot didn’t bother to take the year to improve their chances when they were interested in primary care specialties. I really don’t blame anyone for not memorizing obscure cell bio when they want rural FM. I wouldn’t.

Isnt studying for the usmle the same as comlex though? Why would they randomly drop one?

Comlex is less intense. I really think focusing on doing well in your classes and watching sketchy micro a couple times could net a lot of people a 500+ score. Instead our schools push a free combank down our throats and it hurts so many students. I also think there’s a lot of students who are, for whatever reason, incredibly cocky and feel like they shouldn’t have to do anything for comlex. I remember some primary care bound people desperately just get to passing score level before dedicated started. They wanted to just take it ASAP and use dedicated as vacation.

 

[Angus Avagadro]

Those people are the minority and they're vocal about it. The data shows that the average DO has a higher %ile COMLEX than USMLE.
Probably due to a combination of

The DO average isn't even a 220. I believe SGU is 221. KCU 228 (most but not everyone takes it), a few "top" DO schools in the 215-ish range, the low tiers around 210.

Most USMD average 230-245 and the average is brought down by DO/IMG.

1) Study plan focused on Step 1 (No Comquest or whatever)
2) Wanted to just pass COMLEX because their NBMEs were high enough
3) Were tired/burnt out after step and took COMLEX 3-7 days later
4) Didn't study any OMM (I believe you folks call it "green book")

Similarly, you can make the argument that anyone can become a millionaire straight out of high school without college - by driving a truck then becoming an owner-operator and hiring others, or becoming a mechanic and buying their own shop. But again - minority of people do that.

I could care less what my doctor scored on step. In fact, many of mine have been DOs. There are lots of amazing doctors out there with

These are from Charting outcomes 2020.
I don't know where you get your Data from. You said the avg DO Step 1 was not even a 220. I agree. The avg score of DOs who matched was 228. The avg MD was 234. The avg MD who did not match was 226. The avg score for DOs who did not match was 223. So a couple points difference. Maybe you could share your source with the rest of us? . I would be curious.

 

[DOVinciRobot]

I don't understand what you're saying? Are you saying that people who busted their ass to get into medical school all of a sudden decide to call it quits and not study a little bit more for a difficult exam - an exam that can drastically impact their 30-50 year career?

Nobody capable of passing decides to just "not take USMLE". Those who never take it are the ones who can't get a passing NBME score after weeks and months of studying.

There are a lot of people who could definitely pass that just don’t take it. Some of it is bad advising, falsely believing PDs won’t care, and I legit know more than a few people who have drunk the DO kool aid and said (verbatim), “why would I want to go to a residency program that wouldn’t accept my DO test? They clearly don’t want DOs.”

Most USMD average 230-245 and the average is brought down by DO/IMG.

Nope. The average Step score is set by USMDs only. DOs and IMGs are not factored into the scaling of the exam.

 

[benruitz98]

These are from Charting outcomes 2020.
I don't know where you get your Data from. You said the avg DO Step 1 was not even a 220. I agree. The avg score of DOs who matched was 228. The avg MD was 234. The avg MD who did not match was 226. The avg score for DOs who did not match was 223. So a couple points difference. Maybe you could share your source with the rest of us? . I would be curious.

Ok close enough.

Again, DOs can choose to hide their scores if they bomb USMLE and many do so (there was another 2 posts like that just today). Since only the top of the crop of each school take USMLE it's no surprise 228 is the average. If everyone took it it would be far lower. Even "top" schools like MSU only have an average of 217-220. All of these things taken into consideration bring up the average.

If we used the same formula for MD by only using the top 60-70% the average would undoubtedly be 240+

Osteopathic Medical School Statistics - Google Sheets

My educated guess is the schools with >506 MCAT average are the same schools where the top half of the class is bringing the average up. I know for a fact from friends at some the weaker school that their class average was <215 with a significant percent not taking it or taking it twice.

If EVERY DO school was averaging 220+ you bet your ass they would brag about it. The fact of the matter is schools like KCU, PCOM, AZCOM, Touro etc are bringing up the average, the top 20% at every school is probably doing decent, and most at the weaker schools like ICOM, CUSOM, KYCOM, LMU, are not breaking 210

I don't think anyone is fooled that matriculants with lower MCAT/GPA somehow turned into amazing test takers - and that's okay. I don't judge someone's ability to be a good doctor based on their step score. I could care less what school you went to. My PCP is a Caribbean grad and I absolutely love him. However, we all need to be transparent and there must be standards. We can't collectively fight against scope-creep when you have some DO schools that have virtually non-existent rotations (I literally witnessed this from my friends and their classmates who stayed home all year long)

Otherwise, what's stopping NPs and PAs saying "oh, well some medical schools aren't even doing all that much so what makes them different than us?" Some of the top PA students at my sister school could run circles around some DO students. Take NinjaNerd (From youtube) for example. He's a PA from PCOM and his basic science knowledge is better than mine and probably better than that of many med students.

 

[DOVinciRobot]

Ok close enough.

Again, DOs can choose to hide their scores if they bomb USMLE and many do so (there was another 2 posts like that just today). Since only the top of the crop of each school take USMLE it's no surprise 228 is the average. If everyone took it it would be far lower. Even "top" schools like MSU only have an average of 217-220. All of these things taken into consideration bring up the average.

If we used the same formula for MD by only using the top 60-70% the average would undoubtedly be 240+

Osteopathic Medical School Statistics - Google Sheets

My educated guess is the schools with >506 MCAT average are the same schools where the top half of the class is bringing the average up. I know for a fact from friends at some the weaker school that their class average was <215 with a significant percent not taking it or taking it twice.

If EVERY DO school was averaging 220+ you bet your ass they would brag about it. The fact of the matter is schools like KCU, PCOM, AZCOM, Touro etc are bringing up the average, the top 20% at every school is probably doing decent, and most at the weaker schools like ICOM, CUSOM, KYCOM, LMU, are not breaking 210

I don't think anyone is fooled that matriculants with lower MCAT/GPA somehow turned into amazing test takers - and that's okay. I don't judge someone's ability to be a good doctor based on their step score. I could care less what school you went to. My PCP is a Caribbean grad and I absolutely love him. However, we all need to be transparent and there must be standards. We can't collectively fight against scope-creep when you have some DO schools that have virtually non-existent rotations (I literally witnessed this from my friends and their classmates who stayed home all year long)

Otherwise, what's stopping NPs and PAs saying "oh, well some medical schools aren't even doing all that much so what makes them different than us?" Some of the top PA students at my sister school could run circles around some DO students. Take NinjaNerd (From youtube) for example. He's a PA from PCOM and his basic science knowledge is better than mine and probably better than that of many med students.

I think the night assumption you are making that is wrong is that it’s only the top half of the DO population that only takes Step. At my school at least about 30% of the class took Step, our average was a 225, and only about half of those 30% would be considered top students. The rest of the test takers were actually people in the 3rd and 4th quartiles who knew they wanted to try and get a specialty above their rank, or have some geographic flexibility. I don’t think this is a rare phenomenon. I know multiple people in the top 20% in our class who just didn’t take Step for one reason or another.

Yeah sure we had a number of 200s-210s, but based on where those people were in the class it wasn’t surprising.

I agree with the other posters that if all DO students had to take Step 1 a lot more would pass than you are insinuating. Simply passing is not a very high bar

 

[benruitz98]

I think the night assumption you are making that is wrong is that it’s only the top half of the DO population that only takes Step. At my school at least about 30% of the class took Step, our average was a 225, and only about half of those 30% would be considered top students. The rest of the test takers were actually people in the 3rd and 4th quartiles who knew they wanted to try and get a specialty above their rank, or have some geographic flexibility. I don’t think this is a rare phenomenon. I know multiple people in the top 20% in our class who just didn’t take Step for one reason or another.

Yeah sure we had a number of 200s-210s, but based on where those people were in the class it wasn’t surprising.

I agree with the other posters that if all DO students had to take Step 1 a lot more would pass than you are insinuating. Simply passing is not a very high bar

Fair enough. Until we have 100% of DOs taking and sharing their results then we can't just make assumptions. My friend had a 4.0 in undergrad (hard af to achieve) but low MCAT, and didn't do too well on USMLE (okay-ish COMLEX). For all we know those people just focused on class material or OMM. Again, can't assume things. There are even people with 4.0/515 who end up failing out of MD school. We can't just take their word if they say "Oh I decided to drop out cuz medicine wasn't for me. I COULD have passed but I didn't really feel like it"

People have diff priorities and that's okay. If someone knows they want FM in their hometown in kentucky and just want to do the bare minimum to score ~420 on comlex there's no shame in that - In fact it's smart because it's saving them a bunch of time and stress.

 

[Angus Avagadro]

Fair enough. Until we have 100% of DOs taking and sharing their results then we can't just make assumptions. My friend had a 4.0 in undergrad (hard af to achieve) but low MCAT, and didn't do too well on USMLE (okay-ish COMLEX). For all we know those people just focused on class material or OMM. Again, can't assume things. There are even people with 4.0/515 who end up failing out of MD school. We can't just take their word if they say "Oh I decided to drop out cuz medicine wasn't for me. I COULD have passed but I didn't really feel like it"

People have diff priorities and that's okay. If someone knows they want FM in their hometown in kentucky and just want to do the bare minimum to score ~420 on comlex there's no shame in that - In fact it's smart because it's saving them a bunch of time and stress.

This will be my last response. I'm glad you admitted you were making some assumptions . As you move on in medicine you will come to learn this can be risky. Better to rely on data than assumptions and anecdotal information. Remember the old saying about what happens when you A$$ u me. You never mentioned where your data came from. At this point, I see your statements are mostly assumptions and opinions, which is fine, just not accurate. As I said, our school mandates both Comlex and USMLE. You have to hit a prescribed score on practice exams before you can take it. The lowest Step 1 score in any LOR I wrote this year was 233. I agree there needs to be more transparency and recognition of both boards. Ideally, all would take USMLE with an OMM component for DOs. I believe this is the direction where things are headed.